Featured Research

from universities, journals, and other organizations

New guidelines deem 13 million more Americans eligible for statins

Date:

March 19, 2014

Source:

Duke Medicine

Summary:

New guidelines for using statins to treat high cholesterol and prevent cardiovascular disease are projected to result in 12.8 million more U.S. adults taking the drugs, according to a new research. The new guidelines expand the criteria for statin use to include people whose 10-year risk of developing cardiovascular disease, including stroke, is elevated based on a risk-assessment score.

Share This

New guidelines for using statins to treat high cholesterol and prevent cardiovascular disease are projected to result in 12.8 million more U.S. adults taking the drugs, according to a research team led by Duke Medicine scientists.

New guidelines for using statins to treat high cholesterol and prevent cardiovascular disease are projected to result in 12.8 million more U.S. adults taking the drugs, according to a research team led by Duke Medicine scientists.

Related Articles

The findings for the first time quantify the impact of the American Heart Association's new guidelines, which were issued in November and generated both controversy and speculation about who should be given a prescription for statins.

In an analysis of health data published online March 19, 2014, in the New England Journal of Medicine, a team led by researchers at the Duke Clinical Research Institute found that most of the additional statin users under the new guidelines would be people older than age 60.

"We sought to do a principled, scientific study to try to answer how the new guidelines might affect statin use, particularly as they focused eligibility on patients with an increased risk of developing cardiovascular disease," said lead author Michael J. Pencina, Ph.D., professor of biostatistics at DCRI. "By our estimate, there might be an uptake in usage as a result of the guidelines, from 43.2 million people to 56 million, which is nearly half of the U.S. population between the ages of 40 and 75."

Pencina and colleagues from McGill University and Boston University used the National Health and Nutrition Examination Surveys (NHANES) for their analysis, focusing on 3,773 participants between the ages of 40-75 who had provided detailed medical information, including fasting cholesterol levels from blood tests.

The new guidelines expand the criteria for statin use to include people whose 10-year risk of developing cardiovascular disease, including stroke, is elevated based on a risk-assessment score.

The DCRI-led research team determined that the new guidelines could result in 49 percent of U.S. adults ages 40-75 being recommended for statin therapy, an increase from 38 percent.

The increase is much more pronounced among adults free of cardiovascular disease who are over age 60, with 77 percent recommended for statin use under the new guidelines vs. 48 percent under the previous standards. This contrasts with a modest increase from 27 percent to 30 percent among U.S. adults between the ages of 40 and 60.

Those most affected by the new recommendations are older men who are not on statins and do not have cardiovascular disease. Under the earlier guidelines, about 30.4 percent of this group of men between the ages of 60-75 were recommended for statin use. With the new guidelines, 87.4 percent of these men would be candidates for the therapy. Similarly for healthy women in this age group, those recommended for preventive statin use are projected to rise from 21.2 percent to 53.6 percent.

"The biggest surprise of the research was the age-dependent split for those affected by the new guidelines," Pencina said. "We anticipated that the impact would be age-dependent, but not to the degree observed. The changes for both men and women in the older age groups where huge compared to those between the ages of 40 and 60."

Overall, of the 12.8 million additional U.S. adults recommended for statin use under the new guidelines, 10.4 million are people who would be prescribed the drugs for preventive care. Of those preventive users, 8.3 million would be people over the age of 60.

The analysis also projects that an estimated 1.6 million adults previously eligible for statins under the old guidelines would no longer be candidates under the new standards. This group included primarily younger adults with elevated cholesterol but low 10-year risk of cardiovascular disease.

Pencina said an important limitation of the study is the necessary assumption that the new guidelines would be followed to the letter; in real life, people may be recommended for statins but decline to start the therapy.

"Recommendations are just that -- recommendations," Pencina said. "These guidelines correctly call for a thorough discussion between the doctor and patient about the risks and benefits of statins. It's not like everybody who meets the guidelines should all of a sudden go on statins."

Featured Research

Mar. 31, 2015  Researchers have illuminated an important distinction between mice and humans: how human livers heal. The difference centers on a protein called PPAR alpha which activates liver ... full story

Mar. 31, 2015  Researchers have recorded the first direct observations of the micro-scale mechanisms behind the ability of skin to resist tearing. The results could be applied to the improvement of artificial skin, ... full story

Mar. 31, 2015  Fewer than half of the physicians trained in the United States in 2013 received formal education or training on the subject of exercise, according to new research. "There are immense medical benefits ... full story

Mar. 31, 2015  Memory and as well as connections between brain cells were restored in mice with a model of Alzheimer's given an experimental cancer drug, researchers report. "With this treatment, cells under ... full story

Mar. 31, 2015  Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and ... full story

Mar. 31, 2015  Alcoholism takes a toll on every aspect of a person's life, including skin problems. Now, a new research report helps explain why this happens and what might be done to address it. "The clinical ... full story

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Related Stories

Jan. 9, 2015  A large international study has shown conclusively that statin treatment reduces the risk of cardiovascular disease in women. The research confirms that statins are beneficial not only to women who ... full story

Nov. 24, 2014  Nearly all individuals in their late 60s and early 70s now qualify for a statin medication to reduce their risk of cardiovascular disease under the recently released cholesterol guidelines from the ... full story

Aug. 26, 2014  New national guidelines can improve the way statin drugs are prescribed to patients at risk for cardiovascular disease, a study has found. The research also showed the new guidelines produce only a ... full story

Aug. 18, 2014  Recently introduced cholesterol guidelines would significantly reduce new cardiovascular events, when compared to treatment based on previous cholesterol guidelines, a group of researchers has ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.